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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1990-6-19
pubmed:abstractText
Forty patients were operated on in the early phase of active endocarditis between 1980 and 1988. Indications for operation were heart failure (30 patients), severe valvular regurgitation (4), uncontrolled sepsis (2), septic emboli (3), and other (1 patient). Time between onset of endocarditis symptoms and operation ranged from 12 to 45 days (mean, 30 days). The aortic valve was involved in 3 patients; the mitral valve, in 28; both valves, in 7; and the tricuspid valve, in 2. There was no previous underlying valve pathology in 40%. Lesions found were cusp perforation (17 patients), annular abscess (4), vegetation (13), and chordal rupture (22). Positive blood cultures were found in 30 patients (75%). Bacterial findings were Streptococcus in 12 patients (30%), Staphylococcus in 15 (37.5%), gram-negative in 3 (7.5%), and unknown in 10 (25%). Criteria to perform valve repair were adequate antibiotic therapy for at least 1 week and large excision of all macroscopically involved tissues. In all cases, Carpentier's reconstructive techniques were used. Perioperative mortality was 2.5% (1 patient). Reoperation was necessary in 1 patient. Late mortality was 2.5% (1 patient). Repair was assessed either by angiography or by Doppler echocardiography before hospital discharge: 32 patients showed no regurgitation, whereas 7 had mild regurgitation (3 aortic, 4 mitral). Mean follow-up of 30 months was achieved in all survivors. There was no recurrence of endocarditis and no reoperation for valvular insufficiency. We conclude that valve repair in acute endocarditis is possible and effective in most instances.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0003-4975
pubmed:author
pubmed:issnType
Print
pubmed:volume
49
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
706-11; discussion 712-3
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:2339926-Acute Disease, pubmed-meshheading:2339926-Adolescent, pubmed-meshheading:2339926-Adult, pubmed-meshheading:2339926-Aged, pubmed-meshheading:2339926-Bacterial Infections, pubmed-meshheading:2339926-Child, pubmed-meshheading:2339926-Child, Preschool, pubmed-meshheading:2339926-Endocarditis, Bacterial, pubmed-meshheading:2339926-Female, pubmed-meshheading:2339926-Follow-Up Studies, pubmed-meshheading:2339926-Heart Valve Diseases, pubmed-meshheading:2339926-Humans, pubmed-meshheading:2339926-Male, pubmed-meshheading:2339926-Middle Aged, pubmed-meshheading:2339926-Postoperative Complications, pubmed-meshheading:2339926-Prognosis, pubmed-meshheading:2339926-Reoperation, pubmed-meshheading:2339926-Staphylococcal Infections, pubmed-meshheading:2339926-Streptococcal Infections
pubmed:year
1990
pubmed:articleTitle
Valve repair in acute endocarditis.
pubmed:affiliation
Department of Cardiovascular Surgery, Hôpital Broussais, Paris, France.
pubmed:publicationType
Journal Article